Payment Integrity DRG Coding & Validation Analyst

Lifetime Workforce Solutions, LLC; City of Rochester (NY); On-site; USD 65,346 - 142,322; Full time

Job summary

Lifetime Workforce Solutions, LLC is seeking a Payment Integrity DRG Coding & Clinical Validation Analyst. This role requires a solid background in acute facility-based clinical documentation, inpatient coding, and a strong understanding of MS-DRG and APR-DRG systems.

The ideal candidate will analyze and audit acute inpatient claims, manage coding guidelines compliance, and provide mentorship. Extensive experience with ICD-10 coding and claims auditing is essential. The compensation ranges based on experience and level, with potential earnings extending up to $142,322 for Level III.

Qualifications

• 3+ years experience in claims auditing and DRG coding for hospital settings.
• Intermediate knowledge in software and analysis tools.
• Coding Certification must be maintained.

Responsibilities

• Analyze and audit acute inpatient claims.
• Ensure accurate payment using DRG grouper.
• Oversee complex medical coding assignments.

Skills

Analytical skills

Problem solving

ICD-10 coding expertise

Knowledge of claims auditing

Education

Associate or bachelor's degree in health information management or Nursing Degree

Tools

Auditing tools

Claims processing systems

PC and Software

Job description

Lifetime Workforce Solutions, LLC is seeking a Payment Integrity DRG Coding & Clinical Validation Analyst. This role requires a solid background in acute facility-based clinical documentation, inpatient coding, and a strong understanding of MS-DRG and APR-DRG systems.

The ideal candidate will analyze and audit acute inpatient claims, manage coding guidelines compliance, and provide mentorship. Extensive experience with ICD-10 coding and claims auditing is essential. The compensation ranges based on experience and level, with potential earnings extending up to $142,322 for Level III.